Massive glibenclamide overdose without hypoglycaemia in a man with diabetes after partial pancreatectomy

A 49-year-old man with non-insulin-dependent diabetes mellitus (NIDDM) from alcoholic pancreatitis took 100 mg of glibenclamide without symptoms of hypoglycaemia even when glibenclamide concentrations were high (191 micrograms/l). There was no increase in serum C-peptide concentration. The observed half-life of glibenclamide was 6 h. It is concluded that high doses of glibenclamide will not provoke pancreatic insulin secretion in NIDDM caused by pancreatic destruction, there was no evidence for an acute extra-pancreatic effect of glibenclamide and the elimination of glibenclamide may be slower than supposed previously.